Predictors of Readmission, for Patients with Chronic Obstructive Pulmonary Disease (COPD) &ndash; A Systematic Review

Ronald Chow; Olivia W So; James HB Im; Kenneth R Chapman; Ani Orchanian-Cheff; Andrea S Gershon; Robert Wu

doi:10.2147/COPD.S418295

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Review

Predictors of Readmission, for Patients with Chronic Obstructive Pulmonary Disease (COPD) – A Systematic Review

Authors Chow R , So OW, Im JHB, Chapman KR, Orchanian-Cheff A , Gershon AS, Wu R

Received 22 April 2023

Accepted for publication 8 August 2023

Published 18 November 2023 Volume 2023:18 Pages 2581—2617

DOI https://doi.org/10.2147/COPD.S418295

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Min Zhang

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Ronald Chow,¹ Olivia W So,¹ James HB Im,² Kenneth R Chapman,¹ Ani Orchanian-Cheff,¹ Andrea S Gershon,³ Robert Wu¹

¹University Health Network, University of Toronto, Toronto, ON, Canada; ²The Hospital for Sick Children, Toronto, ON, Canada; ³Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada

Correspondence: Ronald Chow, University Health Network, University of Toronto, Toronto, ON, Canada, Email [email protected]

Introduction: Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death globally and is responsible for over 3 million deaths annually. One of the factors contributing to the significant healthcare burden for these patients is readmission. The aim of this review is to describe significant predictors and prediction scores for all-cause and COPD-related readmission among patients with COPD.
Methods: A search was conducted in Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, from database inception to June 7, 2022. Studies were included if they reported on patients at least 40 years old with COPD, readmission data within 1 year, and predictors of readmission. Study quality was assessed. Significant predictors of readmission and the degree of significance, as noted by the p-value, were extracted for each study. This review was registered on PROSPERO (CRD42022337035).
Results: In total, 242 articles reporting on 16,471,096 patients were included. There was a low risk of bias across the literature. Of these, 153 studies were observational, reporting on predictors; 57 studies were observational studies reporting on interventions; and 32 were randomized controlled trials of interventions. Sixty-four significant predictors for all-cause readmission and 23 for COPD-related readmission were reported across the literature. Significant predictors included 1) pre-admission patient characteristics, such as male sex, prior hospitalization, poor performance status, number and type of comorbidities, and use of long-term oxygen; 2) hospitalization details, such as length of stay, use of corticosteroids, and use of ventilatory support; 3) results of investigations, including anemia, lower FEV₁, and higher eosinophil count; and 4) discharge characteristics, including use of home oxygen and discharge to long-term care or a skilled nursing facility.
Conclusion: The findings from this review may enable better predictive modeling and can be used by clinicians to better inform their clinical gestalt of readmission risk.

Keywords: predictors, readmission, chronic obstructive pulmonary disease

Introduction

Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterized by persistent airflow limitation¹ and is thought to affect over 10% of the population.² As a consequence of its chronicity, COPD is responsible for over 3 million deaths globally, making it the third most common cause of death.³

Patients with COPD commonly require hospitalized care, and COPD is one of the most common causes of hospitalization, among chronic diseases.⁴ Moreover, a notable proportion of patients with COPD will be readmitted, making readmission one of the factors contributing to the significant healthcare burden for these patients. It has been estimated that up to 50% of patients diagnosed with COPD are readmitted within 30 days of initial discharge in the USA.⁵ In addition to the utilization of healthcare resources, readmission is associated with a worse overall prognosis.⁶ Over the past decade, there has been an increased interest in identifying predictors and predictive models for readmission.⁷ Several systematic reviews have attempted to summarize the literature, but they only focused on all-cause or COPD-related readmission alone, and/or did not undertake a quality assessment of the included studies.^8–10 In addition, given the rapidly developing literature, with many studies being reported in the past few years, these systematic reviews may not account for current findings.

The aim of this systematic review is to describe significant predictors and prediction scores for all-cause and COPD-related readmission among patients with COPD.

Methods

This review was registered a priori on PROSPERO (CRD42022337035) and reported as per the PRISMA statement.

Search Strategy

A comprehensive search strategy was developed for Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from database inception to June 7, 2022, using a combination of database-specific subject headings and text words for the main concepts of COPD and hospital readmissions. An expanded search filter for clinical prediction guides was used. Results were limited to adult human studies. No other limits were applied (Appendix 1).

Eligibility Criteria

Two review authors (RC, OWS) independently screened articles for their eligibility for inclusion. A calibration exercise of 20 articles was undertaken to ensure concordance between reviewers. Discrepancies were resolved by discussion and consensus. If consensus could not be achieved, a third review author (RW) participated in the discussion to resolve discrepancies.

Articles were eligible after level 1 title and abstract screening, if they reported on primary research articles reporting on patients with COPD and readmission. Secondary research articles, such as review articles and economic analyses, as well as editorials/commentaries, were excluded at this stage. Studies included after level 2 full-text screening eligibility criteria required studies to report on patients at least 40 years old with COPD, readmission data within 1 year of a COPD hospitalization, and predictors of readmission. Studies including patients admitted for reasons unrelated to acute exacerbations of COPD (eg pneumonia, acute hypercapnic respiratory failure, obstructive sleep apnea, lung cancer, anxiety/depression) and studies reporting on home care/telemonitoring were excluded at this stage, to limit included articles to only patients with COPD.

Data Extraction

Two of the three review authors (RC, OWS, JHBI) conducted data extraction. As with screening, discrepancies were resolved by discussion and consensus, with or without the input of a third reviewer (RW). Study characteristics of country, sample size, age of participants, and percentage of females enrolled in study were noted. Studies were classified as either assessing predictors or assessing interventions. Studies assessing interventions were further subclassified as either observational cohort studies or randomized controlled trials. Significant predictors of readmission and the degree of significance, as noted by the p-value, were extracted for each study. For studies that did not report p-values, p-values were calculated based on the provided statistics (eg odds ratio and 95% confidence intervals) where possible.

Study Quality

Study quality was assessed for each study. For randomized controlled trials, the risk of bias version 2 tool was used.¹¹ For observational studies reporting on interventions, the ROBINS-I tool was used.¹² For observational studies reporting on predictors, the ROBINS-E tool was used.¹³

Synthesis

Significant predictors were reported by the time of readmission post-discharge and the degree of significance. Predictors were reported as significant predictors for the timepoint of 1-month readmission, the interval of 2–3-month readmission, and the interval of 6–12-month readmission. Predictors were further reported based on whether they were significant at a type I error of 0.05, type I error of 0.01, or no degree of significance available. Significant predictors, as reported by the authors (Supplementary Tables 1 and 2), were grouped together into similarly reported predictors across the literature (eg all mentions of hospital length of stay were grouped together).

Because of the non-uniform reporting of non-significant predictors, where some studies explicitly reported non-significant predictors in the methods/results and others only mentioned significant predictors, non-significant predictors were not presented.

Results

In total, 4035 articles were identified from the database search. After 970 duplicates were removed, 3065 records were screened. Ultimately, 242 articles^14–255 reporting on 16,471,096 patients were included in this review (Figure 1). Across the literature, there was generally a low risk of bias (Figure 2).

Figure 1 PRISMA flow diagram.

Figure 2 Quality assessment: (a) studies assessing predictors (ROBINS-E); (b) cohort studies assessing interventions (ROBINS-I); (c) randomized controlled trials assessing interventions (RoB 2).

Overall, 153 studies were observational studies reporting on predictors; 57 studies were observational studies reporting on interventions; and 32 were randomized controlled trials of interventions. The studies were published between 1997 and 2022, with over half of the studies published since 2017. Over one-third of articles (91 studies, 37.6%) originated from the USA; 31 (12.8%) studies originated from Spain, 14 (5.8%) from Canada, 13 (5.4%) from the UK, and 13 (5.4%) from China. Sample sizes ranged from 8 to 4,587,542. The mean/median age was greater than 60 years for nearly all studies. The percentage of females in a study ranged from 0.0% to 80.0%. Individual study characteristics are reported in Table 1 and Table 2.

Table 1 Studies Assessing Predictors

Table 2 Studies Assessing Interventions

A total of 64 significant predictors for all-cause readmission were reported across the literature. Summarizing across all readmission time frames, male sex, prior hospitalization, poorer performance status/activities of daily living, and older age were the most frequently reported patient characteristics that were predictors of readmission. Other significant predictors were COPD severity, alcohol/drug abuse, malnutrition, and history of community-acquired pneumonia (Figure 3a). Heart failure, mental health comorbidity, higher Charlson comorbidity index, diabetes, higher number of comorbidities, chronic kidney disease, and cancer were among the most commonly reported comorbidity predictors of readmission (Figure 3b). Among medications used prior to admission that were significant of readmission, long-term oxygen therapy was the most commonly reported predictor (Figure 3c). Hospital length of stay, non-invasive ventilation, intubation, and admission to the intensive care unit were the most common hospital care predictors of readmission (Figure 3d). Among laboratory values, lower FEV₁ and anemia were the most common predictors (Figure 3e). Use of systemic corticosteroids during hospital admission was the most frequently reported predictor of readmission, among medications used during admission (Figure 3f). Discharge to long-term care or a skilled nursing facility was the most commonly reported predictor of readmission, of assessed predictors after admission (Figure 3f–h). Degrees of significance, and the specific studies reporting on each significant predictor, are reported in Table 3.

Figure 3 Continued.

Figure 3 Significant predictors of all-cause readmission: (a) patient characteristics; (b) comorbidities; (c) medications prior to admission; (d) hospital care; (e) investigations; (f) medications during hospitalization; (g) medications on discharge; (h) disposition.

Table 3 Significant Predictors for All-Cause Readmission

For COPD-related readmission, 23 significant predictors were found. The most common patient characteristics that were predictors were older age and prior hospitalization (Figure 4a). Mental health comorbidity, diabetes, high Charlson/Elixhauser comorbidity index, and cancer were the most frequently reported comorbidity predictors of readmission (Figure 4b). Longer hospital length of stay, higher eosinophil count, and home oxygen after discharge were also frequently reported predictors of readmission (Figure 4c and e). Degrees of significance, and the specific studies reporting on each significant predictor, are reported in Table 4.

Figure 4 Significant predictors of COPD-related readmission: (a) patient characteristics; (b) comorbidities; (c) hospital care; (d) investigations; (e) medications on discharge.

Table 4 Significant Predictors of COPD-Related Readmission

Six prediction scores – the BODEX index,²³ CODEX index,²³ CORE score,²⁴⁷ DOSE index,²³ PEARL score,¹⁴³ and RACE scale¹⁵¹ – were reported to be predictive of all-cause readmission. The included components of each prediction score are reported in Table 5. CORE, PEARL, and RACE were reported to have good predictive value for readmission as a time-to-event outcome variable. The BODEX index, CODEX index, and DOSE index were reported to have good predictive ability for 2–3-month readmission. The CODEX index was reported to have good predictive ability for 6–12-month readmission (Table 3).

Table 5 Characteristics of Prediction Scores

Some studies reported significant interventions that can reduce all-cause and COPD-related readmission, most notably use of a COPD-specific care package (Supplementary Tables 3 and 4). Most studies reporting on interventions reported that their intervention was not associated with a significant reduction in readmission rates.

Discussion

This is the largest systematic review to date, reporting on predictors for readmission of patients with COPD, with 242 articles reporting on 16,471,096 patients included in this review. We comprehensively report on predictors for both all-cause and COPD-related readmissions, for readmission at 1 month, 2–3 months, and 6–12 months. The included studies originated from around the world, and there was generally a low risk of bias. There were 64 predictors for all-cause readmission and 23 predictors for COPD-specific readmission. Significant predictors for all-cause readmissions included 1) pre-admission patient characteristics, such as male sex, prior hospitalization, poor performance status, number and type of comorbidities, and use of long-term oxygen; 2) hospitalization details, such as length of stay, use of corticosteroids, and use of ventilatory support; 3) results of investigations, including anemia, lower FEV₁, and higher eosinophil count; and 4) discharge characteristics, including the use of home oxygen and discharge to long-term care or a skilled nursing facility.

Several prior systematic reviews have also reported on predictors. Alqahtani et al reviewed 14 studies, stating that comorbidities, previous exacerbations/hospitalizations, and increased length of initial hospital stay were major risk factors for 30- and 90-day all-cause readmission.⁸ Heart failure, renal failure, depression, and alcohol use were also associated with increased 30-day all-cause readmission, with being female described as a protective factor for readmission. Bahadori and Fitzgerald examined 17 studies, and found that previous hospital admission, dyspnea, and oral corticosteroids were significant risk factors for readmission.⁹ Njoku et al reviewed 57 studies, and found that hospitalization in the year prior to index admission, comorbidities (such as asthma), living in a deprived area, and living in/or discharge to a nursing home were key predictors of COPD-related readmission.¹⁰

This review identifies some notable predictors worth highlighting that are not contained in previous studies, which were parsimonious. While prior studies reported heart failure and neuromuscular disease, we identified other significant preadmission comorbidities, including alcohol use, diabetes, and mental health. Similarly, poor performance status and malnutrition were both identified as important predictors of readmission. In-hospital use of critical care, including non-invasive ventilation, invasive ventilation, and ICU stay, was also identified as predictors. Use of steroids was also predictive of readmission; this was probably related to the severity of disease. Eosinophil count was both correlated and inversely correlated in different studies. While all studies excluded corticosteroid use prior to measurement of the eosinophil count, the studies used various cut-offs to define eosinopenia.^{114,135,199,247} Further research to determine the utility of eosinophil count is needed.

With COPD patients having a high all-cause readmission rate of 50%⁵ and being the largest single group of chronic disease patients reported in the literature, identifying those at greatest risk of readmission is a priority as more resources can be directed to this group. This comprehensive systematic review identifies many predictors across multiple domains, including prior to admission, during hospitalization, and post-hospitalization. Current prediction rules for readmissions have areas under the receiver operating characteristics curve in the range 0.70–0.72, and may be limited by lacking variables in all domains (Table 5). The findings from this systematic review can be used to develop other prediction scores with higher predictive power. The findings can also be used in clinical practice to help identify individual patients who may benefit from more resources to reduce their risk of readmission. While most prediction scores for COPD readmission are parsimonious, having five or fewer variables for ease of use, a more complicated model with more predictors may be more accurate. More complex models may be enabled through the increase in electronic patient records, which enable more discrete data elements as well as computer decision support.²⁵⁶

This review was not without limitations. There was heterogeneous reporting on some predictor variables; many studies used different cut-off points for predictor variables. We therefore reported on the general directionality of a predictor variable as it relates to readmission. We have reported the predictors as reported by the studies, using their original cut-off points and without any synthesis, in Supplementary Tables 1 and 2. In addition, we were unable to report non-significant predictors owing to non-uniform reporting and therefore the total number of studies investigating each predictor. It is therefore unclear how many studies investigated specific predictors, and what proportion of them reported significant correlation with readmission. For certain predictors that may not be as well studied (eg malnutrition), there could be underestimation of importance.

It is also important to note that some published literature suggests that not all patients discharged with a diagnosis of “COPD” have spirometrically confirmed COPD, and therefore patients discharged with “COPD” may in fact have other comorbidities, such as congestive heart failure.²⁵⁷ Therefore, caution is needed in the interpretation of some of the included studies, given that they simply included patients with a diagnosis of COPD which may not necessarily be confirmed on spirometry. Future studies could look to assess only patients who have spirometrically confirmed COPD.

There may also be some concerns over the generalizability of individual studies to the larger population of patients with COPD admitted to hospitals. There were three studies^127,190,238 with sample sizes of less than 20, and another three studies^80,134,194 with sample sizes of 20–40 patients. Moreover, there were three studies^98,119,210 with no females included in the sample, and another 52 studies^{20–23,29,32,38,42,51,53,68–70,72,74,88,90,91,94,116,139,143–149,155,159,161–163,173,177,181,182,190,192,193,201–203,209,211,245,247,249,255} where less than 20% of the sample comprised of females. Reassuringly, the significant predictors reported by these studies agree with larger and more representative studies. In addition, a large proportion of the studies originated from the USA, which may make the results of this review more generalizable to the US population and slightly less generalizable to other countries, especially given the lack of a universal healthcare system in the USA and therefore the potential confounding effect on readmissions.

In conclusion, we found that predictors of readmissions after an admission for COPD exacerbation included patient characteristics prior to and at admission, hospitalization management, results from admission investigations, and discharge characteristics. Findings from this review may enable better model generation if predictors from all these domains are included. These findings may also be used to identify new predictors in the different domains and can be used by clinicians to help generate their gestalt of readmission.

Disclosure

The authors report no conflicts of interest in this work.

References

1. Buist AS, McBurnie MA, Vollmer WM, et al. International variation in the prevalence of COPD (The BOLD Study): a population-based prevalence study. Lancet. 2007;370(9589):741–750. doi:10.1016/S0140-6736(07)61377-4

2. Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022;10(5):447–458. doi:10.1016/S2213-2600(21)00511-7

3. World Health Organization. Chronic obstructive pulmonary disease (COPD); 2022. Available from: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)#:~:text=Key%20facts,3.23%20million%20deaths%20in%202019. Accessed August 17, 2022.

4. Hernandez C, Jansa M, Vidal M, et al. The burden of chronic disorders on hospital admissions prompts the need for new modalities of care: a cross-sectional analysis in a tertiary hospital. QJM. 2009;102(3):193–202. doi:10.1093/qjmed/hcn172

5. Rohde J, Joseph A, Tambedou B, et al. Reducing 30-day all-cause acute exacerbation of chronic obstructive pulmonary disease readmission with a multidisciplinary quality improvement project. Cureus. 2021;13:e19917. doi:10.7759/cureus.19917

6. Harries TH, Thornton HV, Crichton S, Schofield P, Gilkes A, White PT. Length of stay of COPD hospital admissions between 2006 and 2010: a retrospective longitudinal study. Int J Chron Obstruct Pulmon Dis. 2015;10:603–611. doi:10.2147/COPD.S77092

7. Bellou V, Belbasis L, Konstantinidis AK, Tzoulaki I, Evangelou E. Prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease: systematic review and critical appraisal. BMJ. 2019;367:l5358. doi:10.1136/bmj.l5358

8. Alqahtani JS, Njoku CM, Bereznicki B, et al. Risk factors for all-cause hospital readmission following exacerbation of COPD: a systematic review and meta-analysis. Eur Respir Rev. 2020;29(156):190166. doi:10.1183/16000617.0166-2019

9. Bahadori K, FitzGerald JM. Risk factors of hospitalization and readmission of patients with COPD exacerbation--systematic review. Int J Chron Obstruct Pulmon Dis. 2007;2(3):241–251.

10. Njoku CM, Alqahtani JS, Wimmer BC, et al. Risk factors and associated outcomes of hospital readmission in COPD: a systematic review. Respir Med. 2020;173:105988. doi:10.1016/j.rmed.2020.105988

11. Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. doi:10.1136/bmj.l4898

12. Sterne JAC, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. doi:10.1136/bmj.i4919

13. Higgins J, Morgan R, Rooney A, et al. Risk of Bias in Non-randomized Studies - of Exposure (ROBINS-E); 2022. Available from: https://www.riskofbias.info/welcome/robins-e-tool. Accessed August 11, 2023.

14. Abrams TE, Vaughan-Sarrazin M, Van der Weg MW. Acute exacerbations of chronic obstructive pulmonary disease and the effect of existing psychiatric comorbidity on subsequent mortality. Psychosomatics. 2011;52(5):441–449. doi:10.1016/j.psym.2011.03.005

15. Abusaada K, Alsaleh L, Herrera V, Du Y, Baig H, Everett G. Comparison of hospital outcomes and resource use in acute COPD exacerbation patients managed by teaching versus nonteaching services in a community hospital. J Eval Clin Pract. 2017;23(3):625–630. doi:10.1111/jep.12688

16. Adamson SL, Burns J, Camp PG, Sin DD, van Eeden SF. Impact of individualized care on readmissions after a hospitalization for acute exacerbation of COPD. Int J Chron Obstruct Pulmon Dis. 2016;11:61–71. doi:10.2147/COPD.S93322

17. Agarwal A, Baechle C, Behara R, Zhu X. A natural language processing framework for assessing hospital readmissions for patients with COPD. IEEE J Biomed Health Inform. 2018;22(2):588–596. doi:10.1109/JBHI.2017.2684121

18. Agarwal A, Zhang W, Kuo Y, Sharma G. Process and outcome measures among COPD patients with a hospitalization cared for by an advance practice provider or primary care physician. PLoS One. 2016;11(2). doi:10.1371/journal.pone.0148522

19. Aksoy E, Gungor S, Agca MC, et al. A revised treatment approach for hospitalized patients with Eosinophilic and Neutrophilic exacerbations of chronic obstructive pulmonary disease. Turk. 2018;19(4):193–200.

20. Al Aqqad SMH, Tangiisuran B, Hyder Ali IA, Md Kassim RMN, Wong JL, Tengku Saifudin TI. Hospitalisation of multiethnic older patients with AECOPD: exploration of the occurrence of anxiety, depression and factors associated with short-term hospital readmission. Clin Respir J. 2017;11(6):960–967. doi:10.1111/crj.12448

21. Almagro P, Barreiro B, De Echaguen AO, et al. Risk factors for hospital readmission in patients with chronic obstructive pulmonary disease. Respiration. 2006;73(3):311–317. doi:10.1159/000088092

22. Almagro P, Cabrera FJ, Diez J, et al. Comorbidities and short-term prognosis in patients hospitalized for acute exacerbation of COPD: the EPOC en servicios de medicina interna (ESMI) study. Chest. 2012;142(5):1126–1133. doi:10.1378/chest.11-2413

23. Almagro P, Soriano JB, Cabrera FJ, et al. Short- and medium-term prognosis in patients hospitalized for COPD exacerbation: the CODEX index. Chest. 2014;145(5):972–980. doi:10.1378/chest.13-1328

24. Alpaydin AO, Ozuygur SS, Sahan C, Tertemiz KC, Russell R. 30-day readmission after an acute exacerbation of chronic obstructive pulmonary disease is associated with cardiovascular comorbidity. Turk Thorac J. 2021;22(5):369–375. doi:10.5152/TurkThoracJ.2021.0189

25. Alqahtani JS, Aldabayan YS, Aldhahir AM, Al Rajeh AM, Mandal S, Hurst JR. Predictors of 30- and 90-day COPD exacerbation readmission: a Prospective Cohort Study. Int J Chron Obstruct Pulmon Dis. 2021;16:2769–2781. doi:10.2147/COPD.S328030

26. Alshehri S, Alalawi M, Makeen A, et al. Short-term versus long-term systemic corticosteroid use in the acute exacerbation of chronic obstructive pulmonary disease patients. Malaysian J Med Sci. 2021;28(1):59–65. doi:10.21315/mjms2021.28.1.8

27. Ankjaergaard KL, Rasmussen DB, Schwaner SH, Andreassen HF, Hansen EF, Wilcke JT. COPD: mortality and readmissions in relation to number of admissions with noninvasive ventilation. COPD. 2017;14(1):30–36. doi:10.1080/15412555.2016.1181160

28. Atwood CE, Bhutani M, Ospina MB, et al. Optimizing COPD acute care patient outcomes using a standardized transition bundle and care-coordinator: a randomized clinical trial. Chest. 2022;162(2):321–330.

29. Bade BC, DeRycke EC, Ramsey C, et al. Sex differences in veterans admitted to the hospital for chronic obstructive pulmonary disease exacerbation. Ann Am Thorac Soc. 2019;16(6):707–714. doi:10.1513/AnnalsATS.201809-615OC

30. Bahadori K, FitzGerald JM, Levy RD, Fera T, Swiston J. Risk factors and outcomes associated with chronic obstructive pulmonary disease exacerbations requiring hospitalization. Can Respir J. 2009;16(4):e43–e9. doi:10.1155/2009/179263

31. Baker CL, Zou KH, Su J. Risk assessment of readmissions following an initial COPD-related hospitalization. Int J Chron Obstruct Pulmon Dis. 2013;8:551–559. doi:10.2147/COPD.S51507

32. Ban A, Ismail A, Harun R, Abdul Rahman A, Sulung S, Syed Mohamed A. Impact of clinical pathway on clinical outcomes in the management of COPD exacerbation. BMC Pulm Med. 2012;12(1). doi:10.1186/1471-2466-12-27

33. Barba R, Casasola GGD, Marco J, et al. Anemia in chronic obstructive pulmonary disease: a readmission prognosis factor. Curr Med Res Opin. 2012;28(4):617–622. doi:10.1185/03007995.2012.675318

34. Bartels W, Adamson S, Leung L, Sin DD, van Eeden SF. Emergency department management of acute exacerbations of chronic obstructive pulmonary disease: factors predicting readmission. Int J Chron Obstruct Pulmon Dis. 2018;13:1647–1654. doi:10.2147/COPD.S163250

35. Bashir B, Schneider D, Naglak MC, Churilla TM, Adelsberger M. Evaluation of prediction strategy and care coordination for COPD readmissions. Hosp Pract. 2016;44(3):123–128. doi:10.1080/21548331.2016.1210472

36. Belanger M, Couillard S, Courteau J, et al. Eosinophil counts in first COPD hospitalizations: a comparison of health service utilization. Int J Chron Obstruct Pulmon Dis. 2018;13:3045–3054. doi:10.2147/COPD.S170743

37. Benzo R, Vickers K, Novotny PJ, et al. Health coaching and chronic obstructive pulmonary disease rehospitalization. A Randomized Study. Am J Respir Crit Care Med. 2016;194(6):672–680. doi:10.1164/rccm.201512-2503OC

38. Bernabeu-Mora R, Garcia-Guillamon G, Valera-Novella E, Gimenez-Gimenez LM, Escolar-Reina P, Medina-Mirapeix F. Frailty is a predictive factor of readmission within 90 days of hospitalization for acute exacerbations of chronic obstructive pulmonary disease: a longitudinal study. Ther Adv Respir Dis. 2017;11(10):383–392. doi:10.1177/1753465817726314

39. Bhatt SP, Wells JM, Iyer AS, et al. Results of a medicare bundled payments for care improvement initiative for chronic obstructive pulmonary disease readmissions. Ann Am Thorac Soc. 2017;14(5):643–648. doi:10.1513/AnnalsATS.201610-775BC

40. Bishwakarma R, Zhang W, Kuo YF, Sharma G. Long-acting bronchodilators with or without inhaled corticosteroids and 30-day readmission in patients hospitalized for COPD. Int J Chron Obstruct Pulmon Dis. 2017;12:477–486. doi:10.2147/COPD.S122354

41. Boeck L, Gencay M, Roth M, et al. Adenovirus-specific IgG maturation as a surrogate marker in acute exacerbations of COPD. Chest. 2014;146(2):339–347. doi:10.1378/chest.13-2307

42. Boixeda R, Capdevila JA, Vicente V, et al. Gamma globulin fraction of the proteinogram and chronic obstructive pulmonary disease exacerbations. Med Clin. 2017;149(3):107–113. doi:10.1016/j.medcli.2016.12.042

43. Bollu V, Ernst FR, Karafilidis J, Rajagopalan K, Robinson SB, Braman SS. Hospital readmissions following initiation of nebulized arformoterol tartrate or nebulized short-acting beta-agonists among inpatients treated for COPD. Int J Chron Obstruct Pulmon Dis. 2013;8:631–639. doi:10.2147/COPD.S52557

44. Bollu V, Guerin A, Gauthier G, Hiscock R, Wu EQ. Readmission Risk in chronic obstructive pulmonary disease patients: comparative study of nebulized beta₂-agonists. Drugs Real World Outcomes. 2017;4(1):33–41. doi:10.1007/s40801-016-0097-y

45. Breyer-Kohansal R, Hartl S, Breyer MK, et al. The European COPD audit: adherence to guidelines, readmission risk and hospital care for acute exacerbations in Austria. Wien Klin Wochenschr. 2019;131(5–6):97–103. doi:10.1007/s00508-019-1441-5

46. Brownridge DJ, Zaidi STR. Retrospective audit of antimicrobial prescribing practices for acute exacerbations of chronic obstructive pulmonary diseases in a large regional hospital. J Clin Pharm Ther. 2017;42(3):301–305. doi:10.1111/jcpt.12514

47. Bucknall CE, Miller G, Lloyd SM, et al. Glasgow supported self-management trial (GSuST) for patients with moderate to severe COPD: randomised controlled trial. BMJ. 2012;344(7849):e1060–e1060. doi:10.1136/bmj.e1060

48. Buhr RG, Jackson NJ, Dubinett SM, Kominski GF, Mangione CM, Ong MK. Factors associated with differential readmission diagnoses following acute exacerbations of chronic obstructive pulmonary disease. J Hospl Med. 2020;15(4):219–227. doi:10.12788/jhm.3367

49. Buhr RG, Jackson NJ, Kominski GF, Dubinett SM, Ong MK, Mangione CM. Comorbidity and thirty-day hospital readmission odds in chronic obstructive pulmonary disease: a comparison of the Charlson and Elixhauser comorbidity indices. BMC Health Serv Res. 2019;19(1):701. doi:10.1186/s12913-019-4549-4

50. Candrilli SD, Dhamane AD, Meyers JL, Kaila S. Factors associated with inpatient readmission among managed care enrollees with COPD. Hosp Pract. 2015;43(4):199–207. doi:10.1080/21548331.2015.1085797

51. Carneiro R, Sousa C, Pinto A, Almeida F, Oliveira JR, Rocha N. Risk factors for readmission after hospital discharge in chronic obstructive pulmonary disease. The role of quality of life indicators. Rev Port Pneumol. 2010;16(5):759–777. doi:10.1016/S0873-2159(15)30070-2

52. Chan FW, Wong FY, Yam CH, et al. Risk factors of hospitalization and readmission of patients with COPD in Hong Kong population: analysis of hospital admission records. BMC Health Serv Res. 2011;11(1):186. doi:10.1186/1472-6963-11-186

53. Chang C, Zhu H, Shen N, Han X, Chen Y, He B. Utility of the combination of serum highly-sensitive C-reactive protein level at discharge and a risk index in predicting readmission for acute exacerbation of COPD. J Bras Pneumol. 2014;40(5):495–503. doi:10.1590/S1806-37132014000500005

54. Chawla H, Bulathsinghala C, Tejada JP, Wakefield D, ZuWallack R. Physical activity as a predictor of thirty-day hospital readmission after a discharge for a clinical exacerbation of chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2014;11(8):1203–1209. doi:10.1513/AnnalsATS.201405-198OC

55. Chen L, Chen S. Prediction of readmission in patients with acute exacerbation of chronic obstructive pulmonary disease within one year after treatment and discharge. BMC Pulm Med. 2021;21(1):1–7.

56. Chen Y, Li Q, Johansen H. Age and sex variations in hospital readmissions for COPD associated with overall and cardiac comorbidity. Int J Tuberc Lung Dis. 2009;13(3):394–399.

57. Chen YJ, Narsavage GL. Factors related to chronic obstructive pulmonary disease readmission in Taiwan. West J Nurs Res. 2006;28(1):105–124. doi:10.1177/0193945905282354

58. Chu CM, Chan VL, Lin AWN, Wong IWY, Leung WS, Lai CKW. Readmission rates and life threatening events in COPD survivors treated with non-invasive ventilation for acute hypercapnic respiratory failure. Thorax. 2004;59(12):1020–1025. doi:10.1136/thx.2004.024307

59. Chung LP, Winship P, Phung S, Lake F, Waterer G. Five-year outcome in COPD patients after their first episode of acute exacerbation treated with non-invasive ventilation. Respirology. 2010;15(7):1084–1091. doi:10.1111/j.1440-1843.2010.01795.x

60. Coban Agca M, Aksoy E, Duman D, et al. Does eosinophilia and neutrophil to lymphocyte ratio affect hospital re-admission in cases of COPD exacerbation? Tuberkuloz ve Toraks. 2017;65(4):282–290. doi:10.5578/tt.57278

61. Collinsworth AW, Brown RM, James CS, Stanford RH, Alemayehu D, Priest EL. The impact of patient education and shared decision making on hospital readmissions for COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:1325–1332. doi:10.2147/COPD.S154414

62. Connolly MJ, Lowe D, Anstey K, Hosker HSR, Pearson MG, Roberts CM. Admissions to hospital with exacerbations of chronic obstructive pulmonary disease: effect of age related factors and service organisation. Thorax. 2006;61(10):843–848. doi:10.1136/thx.2005.054924

63. Conti G, Antonelli M, Navalesi P, et al. Noninvasive vs. conventional mechanical ventilation in patients with chronic obstructive pulmonary disease after failure of medical treatment in the ward: a randomized trial. Intensive Care Med. 2002;28(12):1701–1707. doi:10.1007/s00134-002-1478-0

64. Cope K, Fowler L, Pogson Z. Developing a specialist-nurse-led ‘COPD in-reach service’. Br J Nurs. 2015;24(8):441–445. doi:10.12968/bjon.2015.24.8.441

65. Couillard S, Larivee P, Courteau J, Vanasse A. Eosinophils in COPD exacerbations are associated with increased readmissions. Chest. 2017;151(2):366–373. doi:10.1016/j.chest.2016.10.003

66. Coventry PA, Gemmell I, Todd CJ. Psychosocial risk factors for hospital readmission in COPD patients on early discharge services: a cohort study. BMC Polm. 2011;11:49.

67. Criner GJ, Jacobs MR, Zhao H, Marchetti N. Effects of roflumilast on rehospitalization and mortality in patients. Chronic Obstr Pulm Dis. 2018;6(1):74–85. doi:10.15326/jcopdf.6.1.2018.0139

68. Crisafulli E, Guerrero M, Menendez R, et al. Inhaled corticosteroids do not influence the early inflammatory response and clinical presentation of hospitalized subjects with COPD exacerbation. Respir Care. 2014;59(10):1550–1559. doi:10.4187/respcare.03036

69. Crisafulli E, Torres A, Huerta A, et al. predicting in-hospital treatment failure (<= 7 days) in patients with COPD exacerbation using antibiotics and systemic steroids. COPD. 2016;13(1):82–92. doi:10.3109/15412555.2015.1057276

70. Crisafulli E, Torres A, Huerta A, et al. C-reactive protein at discharge, diabetes mellitus and ≥1 hospitalization during previous year predict early readmission in patients with acute exacerbation of chronic obstructive pulmonary disease. COPD. 2015;12(3):311–320. doi:10.3109/15412555.2014.933954

71. Dalal AA, Shah M, D’Souza AO, Crater GD. Rehospitalization risks and outcomes in COPD patients receiving maintenance pharmacotherapy. Respir Med. 2012;106(6):829–837. doi:10.1016/j.rmed.2011.11.012

72. De Batlle J, Mendez M, Romieu I, et al. Cured meat consumption increases risk of readmission in COPD patients. Eur Respir J. 2012;40(3):555–560. doi:10.1183/09031936.00116911

73. De Jong YP, Uil SM, Grotjohan HP, Postma DS, Kerstjens HAM, Van Den Berg JWK. Oral or IV prednisolone in the treatment of COPD exacerbations: a randomized, controlled, double-blind study. Chest. 2007;132(6):1741–1747. doi:10.1378/chest.07-0208

74. de Miguel-Diez J, Jimenez-Garcia R, Hernandez-Barrera V, et al. Readmissions following an initial hospitalization by COPD exacerbation in Spain from 2006 to 2012. Respirology. 2016;21(3):489–496. doi:10.1111/resp.12705

75. Deutz NE, Ziegler TR, Matheson EM, et al. Reduced mortality risk in malnourished hospitalized older adult patients with COPD treated with a specialized oral nutritional supplement: sub-group analysis of the NOURISH study. Clin Nutr. 2021;40(3):1388–1395. doi:10.1016/j.clnu.2020.08.031

76. Duman D, Aksoy E, Agca MC, et al. The utility of inflammatory markers to predict readmissions and mortality in COPD cases with or without eosinophilia. Int J Chron Obstruct Pulmon Dis. 2015;10:2469–2478. doi:10.2147/COPD.S90330

77. Eaton T, Fergusson W, Kolbe J, Lewis CA, West T. Short-burst oxygen therapy for COPD patients: a 6-month randomised, controlled study. Eur Respir J. 2006;27(4):697–704. doi:10.1183/09031936.06.00098805

78. Eaton T, Young P, Fergusson W, et al. Does early pulmonary rehabilitation reduce acute health-care utilization in COPD patients admitted with an exacerbation? A randomized controlled study. Respirology. 2009;14(2):230–238. doi:10.1111/j.1440-1843.2008.01418.x

79. Ehsani H, Mohler MJ, Golden T, Toosizadeh N. Upper-extremity function prospectively predicts adverse discharge and all-cause COPD readmissions: a pilot study. Int J Chron Obstruct Pulmon Dis. 2019;14:39–49. doi:10.2147/COPD.S182802

80. Emtner MI, Arnardottir HR, Hallin R, Lindberg E, Janson C. Walking distance is a predictor of exacerbations in patients with chronic obstructive pulmonary disease. Respir Med. 2007;101(5):1037–1040. doi:10.1016/j.rmed.2006.09.020

81. Eriksen N, Vestbo J. Management and survival of patients admitted with an exacerbation of COPD: comparison of two Danish patient cohorts. Clin Respir J. 2010;4(4):208–214. doi:10.1111/j.1752-699X.2009.00177.x

82. Ernst P, Dah M, Chateau D, et al. Comparative effectiveness of fluoroquinolone antibiotic use in uncomplicated acute exacerbations of COPD: a multi-cohort study. Int J Chron Obstruct Pulmon Dis. 2019;14:2939–2946. doi:10.2147/COPD.S226324

83. Euceda G, Kong WT, Kapoor A, et al. The effects of a comprehensive care management program on readmission rates after acute exacerbation of COPD at a community-based academic hospital. Chronic Obstr Pulm Dis. 2018;5(3):185–192. doi:10.15326/jcopdf.5.3.2017.0177

84. Fernandez-Garcia S, Represas-Represas C, Ruano-Ravina A, et al. Social and clinical predictors of short- and long-term readmission after a severe exacerbation of copd. PLoS One. 2020;15(2):e0229257. doi:10.1371/journal.pone.0229257

85. Fu AZ, Sun SX, Huang X, Amin AN. Lower 30-day readmission rates with roflumilast treatment among patients hospitalized for chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2015;10:909–915. doi:10.2147/COPD.S83082

86. Ganapathy V, Stensland MD. Health resource utilization for inpatients with COPD treated with nebulized arformoterol or nebulized formoterol. Int J Chron Obstruct Pulmon Dis. 2017;12:1793–1801. doi:10.2147/COPD.S134145

87. Garcia-Aymerich J, Farrero E, Felez MA, Izquierdo J, Marrades RM, Anto JM. Risk factors of readmission to hospital for a COPD exacerbation: a prospective study. Thorax. 2003;58(2):100–105. doi:10.1136/thorax.58.2.100

88. Garcia-Aymerich J, Hernandez C, Alonso A, et al. Effects of an integrated care intervention on risk factors of COPD readmission. Respir Med. 2007;101(7):1462–1469. doi:10.1016/j.rmed.2007.01.012

89. Garcia-Pachon E, Baeza-Martinez C, Ruiz-Alcaraz S, Grau-Delgado J. Prediction of three-month readmission based on haematological parameters in patients with severe COPD exacerbation. Adv Respir Med. 2021;89(5):501–504. doi:10.5603/ARM.a2021.0076

90. Garcia-Sanz MT, Martinez-Gestoso S, Calvo-Alvarez U, et al. Impact of hyponatremia on COPD exacerbation prognosis. J Clin Med. 2020;9(2):12. doi:10.3390/jcm9020503

91. Gavish R, Levy A, Dekel OK, Karp E, Maimon N. The association between hospital readmission and pulmonologist follow-up visits in patients with COPD. Chest. 2015;148(2):375–381. doi:10.1378/chest.14-1453

92. Gay E, Desai S, McNeil D. A multidisciplinary intervention to improve care for high-risk COPD patients. Am J Med Qual. 2020;35(3):231–235. doi:10.1177/1062860619865329

93. Gentene AJ, Guido MR, Woolf B, et al. Multidisciplinary team utilizing pharmacists in multimodal, bundled care reduce chronic obstructive pulmonary disease hospital readmission rates. J Pharm Pract. 2021;34(1):110–116. doi:10.1177/0897190019889440

94. George PP, Heng BH, Lim TK, et al. Evaluation of a disease management program for COPD using propensity matched control group. J Thorac Dis. 2016;8(7):1661–1671. doi:10.21037/jtd.2016.06.05

95. Gerber A, Moynihan C, Klim S, Ritchie P, Kelly AM. Compliance with a COPD bundle of care in an Australian emergency department: a cohort study. Clin Respir J. 2018;12(2):706–711. doi:10.1111/crj.12583

96. Gerrits CM, Herings RM, Leufkens HG, Lammers JW. N-acetylcysteine reduces the risk of re-hospitalisation among patients with chronic obstructive pulmonary disease. Eur Respir J. 2003;21(5):795–798. doi:10.1183/09031936.03.00063402

97. Ghanei M, Aslani J, Azizabadi-Farahani M, Assari S, Saadat SH. Logistic regression model to predict chronic obstructive pulmonary disease exacerbation. Archiv Med Sci. 2007;3(4):360–366.

98. Giron R, Matesanz C, Garcia-Rio F, et al. Nutritional state during COPD exacerbation: clinical and prognostic implications. Ann Nutr Metab. 2009;54(1):52–58. doi:10.1159/000205960

99. Glaser JB, El-Haddad H. Exploring novel medicare readmission risk variables in chronic obstructive pulmonary disease patients at high risk of readmission within 30 days of hospital discharge. Ann Am Thorac Soc. 2015;12(9):1288–1293. doi:10.1513/AnnalsATS.201504-228OC

100. Gonzalez C, Servera E, Marin J. Importance of noninvasively measured respiratory muscle overload among the causes of hospital readmission of COPD patients. Chest. 2008;133(4):941–947. doi:10.1378/chest.07-1796

101. Goto T, Faridi MK, Camargo CA, Hasegawa K. Time-varying readmission diagnoses during 30 days after hospitalization for COPD exacerbation. Med Care. 2018;56(8):673–678. doi:10.1097/MLR.0000000000000940

102. Goto T, Faridi MK, Gibo K, Camargo CA, Hasegawa K. Sex and racial/ethnic differences in the reason for 30-day readmission after COPD hospitalization. Respir Med. 2017;131:6–10. doi:10.1016/j.rmed.2017.07.056

103. Goto T, Yoshida K, Faridi MK, Camargo CA, Hasegawa K. Contribution of social factors to readmissions within 30 days after hospitalization for COPD exacerbation. BMC Pulm Med. 2020;20(1). doi:10.1186/s12890-020-1136-8

104. Gudmundsson G, Gislason T, Janson C, et al. Risk factors for rehospitalisation in COPD: role of health status, anxiety and depression. Eur Respir J. 2005;26(3):414–419. doi:10.1183/09031936.05.00078504

105. Guerrero M, Crisafulli E, Liapikou A, et al. Readmission for acute exacerbation within 30 days of discharge is associated with a subsequent progressive increase in mortality risk in COPD patients: a long-Term observational study. PLoS One. 2016;11(3):e0150737.

106. Gulati S, Zouk AN, Kalehoff JP, et al. The use of a standardized order set reduces systemic corticosteroid dose and length of stay for individuals hospitalized with acute exacerbations of COPD: a cohort study. Int J Chron Obstruct Pulmon Dis. 2018;13:2271–2278. doi:10.2147/COPD.S165665

107. Gunen H, Hacievliyagil SS, Yetkin O, Gulbas G, Mutlu LC, In E. The role of nebulised budesonide in the treatment of exacerbations of COPD. Eur Respir J. 2007;29(4):660–667. doi:10.1183/09031936.00073506

108. Hajizadeh N, Goldfeld K, Crothers K. What happens to patients with COPD with long-term oxygen treatment who receive mechanical ventilation for COPD exacerbation? A 1-year retrospective follow-up study. Thorax. 2015;70(3):294–296. doi:10.1136/thoraxjnl-2014-205248

109. Hakansson KEJ, Ulrik CS, Godtfredsen NS, et al. High suPAR and low blood Eosinophil count are risk factors for hospital readmission and mortality in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2020;15:733–743. doi:10.2147/COPD.S229904

110. Harries TH, Thornton H, Crichton S, Schofield P, Gilkes A, White PT. Hospital readmissions for COPD: a retrospective longitudinal study. NPJ Prim Care Respir Med. 2017;27(1):31.

111. Hartl S, Lopez-Campos JL, Pozo-Rodriguez F, et al. Risk of death and readmission of hospital-admitted COPD exacerbations: European COPD Audit. Eur Respir J. 2016;47(1):113–121. doi:10.1183/13993003.01391-2014

112. Hasegawa K, Camargo CA. Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD. Respirology. 2016;21(4):761–764. doi:10.1111/resp.12724

113. Hegelund A, Andersen IC, Andersen MN, Bodtger U. The impact of a personalised action plan delivered at discharge to patients with COPD on readmissions: a pilot study. Scand J Caring Sci. 2020;34(4):909–918. doi:10.1111/scs.12798

114. Hegewald MJ, Horne BD, Trudo F, et al. Blood Eosinophil count and hospital readmission in patients with acute exacerbation of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2020;15:2629–2641. doi:10.2147/COPD.S251115

115. Hemenway AN, Terry AM. Evaluation of corticosteroid dose in acute exacerbation of chronic obstructive pulmonary disease. Hosp Pharm. 2017;52(8):546–550. doi:10.1177/0018578717722540

116. Huertas D, Monton C, Marin A, et al. Effectiveness of a respiratory day hospital program to reduce admissions for exacerbation in patients with severe COPD: a Prospective, Multicenter Study. COPD. 2017;14(3):304–310. doi:10.1080/15412555.2017.1279598

117. Ingadottir AR, Beck AM, Baldwin C, et al. Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD). Clin Nutr. 2018;37(4):1323–1331. doi:10.1016/j.clnu.2017.05.031

118. Ingadottir AR, Beck AM, Baldwin C, et al. Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease. Br J Nutr. 2018;119(5):543–551. doi:10.1017/S0007114517003919

119. Ip SPS, Leung YF, Choy KL. Short-stay in-patient rehabilitation of elderly patients with chronic obstructive pulmonary disease: prospective study. Hong Kong Med J. 2004;10(5):312–318.

120. Islam EA, Limsuwat C, Nantsupawat T, Berdine GG, Nugent KM. The association between glucose levels and hospital outcomes in patients with acute exacerbations of chronic obstructive pulmonary disease. Ann Thorac Med. 2015;10(2):94–99. doi:10.4103/1817-1737.151439

121. Iyer AS, Bhatt SP, Garner JJ, et al. Depression is associated with readmission for acute exacerbation of chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2016;13(2):197–203. doi:10.1513/AnnalsATS.201507-439OC

122. Jacobs DM, Noyes K, Zhao J, et al. Early hospital readmissions after an acute exacerbation of chronic obstructive pulmonary disease in the nationwide readmissions database. Ann Am Thorac Soc. 2018;15(7):837–845. doi:10.1513/AnnalsATS.201712-913OC

123. Janson C, Nwaru BI, Wiklund F, Telg G, Ekstrom M. Management and risk of mortality in patients hospitalised due to a first severe COPD exacerbation. Int J Chron Obstruct Pulmon Dis. 2020;15:2673–2682. doi:10.2147/COPD.S276819

124. Jeffs KJ, Lim WK, Lim M, Berlowitz DJ, Jackson B. The effect of a post acute respiratory outreach service for patients with chronic obstructive pulmonary disease on hospital readmission rates. Respirology. 2005;10(2):239–243. doi:10.1111/j.1440-1843.2005.00665.x

125. Jennings JH, Thavarajah K, Mendez MP, Eichenhorn M, Kvale P, Yessayan L. Predischarge bundle for patients with acute exacerbations of COPD to reduce readmissions and ED visits: a randomized controlled trial. Chest. 2015;147(5):1227–1234. doi:10.1378/chest.14-1123

126. Jimenez D, Agusti A, Tabernero E, et al. Effect of a pulmonary embolism diagnostic strategy on clinical outcomes in patients hospitalized for COPD exacerbation: a randomized clinical trial. JAMA. 2021;326(13):1277–1285. doi:10.1001/jama.2021.14846

127. Jing Z, Chun C, Ning S, Hong Z, Bei H, Wan-Zhen Y. Systemic inflammatory marker CRP was better predictor of readmission for AECOPD than sputum inflammatory markers. Arch Bronconeumol. 2016;52(3):138–144. doi:10.1016/j.arbres.2015.01.011

128. Jo YS, Rhee CK, Kim KJ, Yoo KH, Park YB. Risk factors for early readmission after acute exacerbation of chronic obstructive pulmonary disease. Therap. 2020;14:1753466620961688.

129. Johannesdottir SA, Christiansen CF, Johansen MB, et al. Hospitalization with acute exacerbation of chronic obstructive pulmonary disease and associated health resource utilization: a population-based Danish cohort study. J Med Econ. 2013;16(7):897–906. doi:10.3111/13696998.2013.800525

130. Jones TPW, Brown J, Hurst JR, Vancheeswaran R, Brill S. COPD exacerbation phenotypes in a real-world five year hospitalisation cohort. Respir Med. 2020;167:105979. doi:10.1016/j.rmed.2020.105979

131. Joyner KR, Walkerly A, Seidel K, et al. Comparison of narrow-versus broad-spectrum antibiotics in elderly patients with acute exacerbations of chronic obstructive pulmonary disease. J Pharm Pract. 2022;35(1):26–31. doi:10.1177/0897190020938190

132. Kasirye Y, Simpson M, Mamillapalli CK, Epperla N, Liang H, Yale SH. Association between blood glucose level and outcomes in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease. WMJ. 2013;112(6):244–9; quiz 50.

133. Kawasumi Y, Paterson MJ, Morrow RL, et al. Comparative effectiveness of tiotropium and ipratropium in prevention of hospital readmission for COPD: a Population-Based Cohort Study. Clin Ther. 2013;35(4):523–31.e1. doi:10.1016/j.clinthera.2012.10.007

134. Kebede AT, Trapnes E, Lea M, Abrahamsen B, Mathiesen L. Effect of pharmacist-led inhaler technique assessment service on readmissions in hospitalized COPD patients: a randomized, controlled pilot study. BMC Polm. 2022;22(1):210.

135. Kerkhof M, Chaudhry I, Pavord ID, et al. Blood eosinophil count predicts treatment failure and hospital readmission for copd. ERJ Open Res. 2020;6(4):1–12. doi:10.1183/23120541.00188-2020

136. Keshishian A, Xie L, Dembek C, Yuce H. Reduction in hospital readmission rates among medicare beneficiaries with chronic obstructive pulmonary disease: a real-world outcomes study of nebulized bronchodilators. Clin Ther. 2019;41(11):2283–2296. doi:10.1016/j.clinthera.2019.09.001

137. Khosravi A, Ravari A, Mirzaei T, Gholamrezapour M. Effects of a comprehensive care program on the readmission rate and adherence to treatment in elderly patients with chronic obstructive pulmonary disease. Tanaffos. 2020;19(4):401–412.

138. Kim J, Lin A, Absher R, Makhlouf T, Wells C. Comprehensive and collaborative pharmacist transitions of care service for underserved patients with chronic obstructive pulmonary disease. COPD. 2020;8(1):152.

139. Kim MH, Lee K, Kim KU, et al. Risk factors associated with frequent hospital readmissions for exacerbation of COPD. Tuberc Respir Dis. 2010;69(4):243–249. doi:10.4046/trd.2010.69.4.243

140. Kim TW, Choi ES, Kim WJ, Jo HS. The association with COPD readmission rate and access to medical institutions in elderly patients. Int J Chron Obstruct Pulmon Dis. 2021;16:1599–1606. doi:10.2147/COPD.S302631

141. Kiri VA, Bettoncelli G, Testi R, Viegi G. Inhaled corticosteroids are more effective in COPD patients when used with LABA than with SABA. Respir Med. 2005;99(9):1115–1124. doi:10.1016/j.rmed.2005.02.018

142. Kiser TH, Reynolds PM, Moss M, et al. Impact of macrolide antibiotics on hospital readmissions and other clinically important outcomes in critically ill patients with acute exacerbations of chronic obstructive pulmonary disease: a Propensity Score-Matched Cohort Study. Pharmacotherapy. 2019;39(3):242–252. doi:10.1002/phar.2221

143. Kishor M, Khippal N, Rathore Y, Jain S, Joshi V. Evaluation of PEARL score in assessing prognosis among patients with acute exacerbation of chronic obstructive pulmonary disease. Egypt J Chest Dis Tuberc. 2020;69(4):627–630. doi:10.4103/ejcdt.ejcdt_5_20

144. Ko FWS, Chan KP, Ngai J, et al. Blood eosinophil count as a predictor of hospital length of stay in COPD exacerbations. Respirology. 2020;25(3):259–266. doi:10.1111/resp.13660

145. Ko FWS, Cheung NK, Rainer TH, Lum C, Wong I, Hui DSC. Comprehensive care programme for patients with chronic obstructive pulmonary disease: a randomised controlled trial. Thorax. 2017;72(2):122–128. doi:10.1136/thoraxjnl-2016-208396

146. Ko FWS, Dai DLK, Ngai J, et al. Effect of early pulmonary rehabilitation on health care utilization and health status in patients hospitalized with acute exacerbations of COPD. Respirology. 2011;16(4):617–624. doi:10.1111/j.1440-1843.2010.01921.x

147. Ko FW, Ngai JC, Ng SS, et al. COPD care programme can reduce readmissions and in-patient bed days. Respir Med. 2014;108(12):1771–1778. doi:10.1016/j.rmed.2014.09.019

148. Ko FW, Tam W, Siu EHS, et al. Effect of short-course exercise training on the frequency of exacerbations and physical activity in patients with COPD: a randomized controlled trial. Respirology. 2021;26(1):72–79. doi:10.1111/resp.13872

149. Lalmolda C, Coll-Fernandez R, Martinez N, et al. Effect of a rehabilitation-based chronic disease management program targeting severe COPD exacerbations on readmission patterns. Int J Chron Obstruct Pulmon Dis. 2017;12:2531–2538. doi:10.2147/COPD.S138451

150. LaRoche KD, Hinkson CR, Thomazin BA, Minton-Foltz PK, Carlbom DJ. Impact of an electronic medical record screening tool and therapist-driven protocol on length of stay and hospital readmission for COPD. Respir Care. 2016;61(9):1137–1143. doi:10.4187/respcare.04588

151. Lau CS, Siracuse BL, Chamberlain RS. Readmission after COPD exacerbation scale: determining 30-day readmission risk for COPD patients. Int J Chron Obstruct Pulmon Dis. 2017;12:1891–1902. doi:10.2147/COPD.S136768

152. Law S, Kumar P, Woods S, Sriram KB. Malnutrition screening in patients admitted to hospital with an exacerbation of chronic obstructive pulmonary disease and its association with patient outcomes. Hosp Pract. 2016;44(4):207–212. doi:10.1080/21548331.2016.1224007

153. Lee Q, Mocarski M, Sun SX. Benefits of early roflumilast treatment after hospital or emergency department discharge for a COPD exacerbation. Am Health Drug Benefits. 2016;9(3):140–149.

154. Lellouche F, Bouchard PA, Roberge M, et al. Automated oxygen titration and weaning with FreeO2 in patients with acute exacerbation of COPD: a pilot randomized trial. Int J Chron Obstruct Pulmon Dis. 2016;11(1):1983–1990. doi:10.2147/COPD.S112820

155. Li J, Zhang H, Ruan H, et al. Effects of Chinese herbal medicine on acute exacerbations of COPD: a Randomized, Placebo-Controlled Study. Int J Chron Obstruct Pulmon Dis. 2020;15:2901–2912. doi:10.2147/COPD.S276082

156. Li T, Gao L, Ma HX, et al. Clinical value of IL-13 and ECP in the serum and sputum of eosinophilic AECOPD patients. Exp Biol Med. 2020;245(14):1290–1298. doi:10.1177/1535370220931765

157. Lindenauer PK, Dharmarajan K, Qin L, Lin Z, Gershon AS, Krumholz HM. Risk trajectories of readmission and death in the first year after hospitalization for chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2018;197(8):1009–1017. doi:10.1164/rccm.201709-1852OC

158. Lindenauer PK, Stefan MS, Shieh MS, Pekow PS, Rothberg MB, Hill NS. Outcomes associated with invasive and noninvasive ventilation among patients hospitalized with exacerbations of chronic obstructive pulmonary disease. JAMA Intern Med. 2014;174(12):1982–1993. doi:10.1001/jamainternmed.2014.5430

159. Liu SF, Lin KC, Chin CH, et al. Factors influencing short-term re-admission and one-year mortality in patients with chronic obstructive pulmonary disease. Respirology. 2007;12(4):560–565. doi:10.1111/j.1440-1843.2007.01110.x

160. Loh CH, Peters SP, Lovings TM, Ohar JA. Suboptimal inspiratory flow rates are associated with chronic obstructive pulmonary disease and all-cause readmissions. Ann Am Thorac Soc. 2017;14(8):1305–1311. doi:10.1513/AnnalsATS.201611-903OC

161. Marcos PJ, Sanjuan P, Huerta A, et al. Relationship between severity classification of acute exacerbation of chronic obstructive pulmonary disease and clinical outcomes in hospitalized patients. Cureus. 2017;9(1):e988. doi:10.7759/cureus.988

162. Martinez-Gestoso S, Garcia-Sanz MT, Calvo-Alvarez U, et al. Variability of blood eosinophil count and prognosis of COPD exacerbations. Ann Med. 2021;53(1):1152–1158. doi:10.1080/07853890.2021.1949489

163. Matsui H, Jo T, Fushimi K, Yasunaga H. Outcomes after early and delayed rehabilitation for exacerbation of chronic obstructive pulmonary disease: a nationwide retrospective cohort study in Japan. Respir Res. 2017;18(1). doi:10.1186/s12931-017-0552-7

164. McGurran MA, Richter LM, Leedahl ND, Leedahl DD. Impact of a comprehensive copd therapeutic interchange program on 30-day readmission rates in hospitalized patients. Pharm Ther. 2019;44(4):185–191. doi:10.2146/ajhp150154.

165. Monreal MF, Sellares J, Anton PA, et al. Discontinuing non-invasive ventilation in severe chronic obstructive pulmonary disease exacerbations: a randomised controlled trial. Eur Respir J. 2016;48:2016–2019.

166. Moullec G, Lavoie KL, Rabhi K, Julien M, Favreau H, Labrecque M. Effect of an integrated care programme on re-hospitalization of patients with chronic obstructive pulmonary disease. Respirology. 2012;17(4):707–714. doi:10.1111/j.1440-1843.2012.02168.x

167. Myers LC, Cash R, Liu VX, Camargo CA. Reducing readmissions for chronic obstructive pulmonary disease in response to the hospital readmissions reduction program. Ann Am Thorac Soc. 2021;18(9):1506–1513. doi:10.1513/AnnalsATS.202007-786OC

168. Myers LC, Faridi MK, Hasegawa K, Camargo CA. Pulmonary rehabilitation and readmission rates for medicare beneficiaries with acute exacerbation of chronic obstructive pulmonary disease. COPD. 2021;8(4):427–440. doi:10.15326/jcopdf.2020.0193

169. Myers LC, Faridi MK, Hasegawa K, Hanania NA, Camargo CA. The hospital readmissions reduction program and readmissions for chronic obstructive pulmonary disease, 2006–2015. Ann Am Thorac Soc. 2020;17(4):450–456. doi:10.1513/AnnalsATS.201909-672OC

170. Nantsupawat T, Limsuwat C, Nugent K. Factors affecting chronic obstructive pulmonary disease early rehospitalization. Chron. 2012;9(2):93–98.

171. Narewski ER, Kim V, Marchetti N, Jacobs MR, Criner GJ. Is methicillin-resistant Staphylococcus aureus colonization associated with worse outcomes in COPD hospitalizations? Chronic Obstr Pulm Dis. 2015;2(3):252–258. doi:10.15326/jcopdf.2.3.2014.0147

172. Nastars DR, Rojas JD, Ottenbacher KJ, Graham JE. Race/ethnicity and 30-day readmission rates in medicare beneficiaries with COPD. Respir Care. 2019;64(8):931–936. doi:10.4187/respcare.06475

173. Ng TP, Niti M, Tan WC, Cao Z, Ong KC, Eng P. Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life. Arch Intern Med. 2007;167(1):60–67. doi:10.1001/archinte.167.1.60

174. Nguyen D, Larson T, Leinbach H, Guthrie E. Systemic steroid and nebulized budesonide combination therapy versus systemic steroid monotherapy in patients with acute exacerbation of chronic obstructive pulmonary disease in a community hospital: a Retrospective Cohort Study. Hosp Pharm. 2021;56(6):786–791. doi:10.1177/0018578720965417

175. Nguyen HQ, Chu L, Liu ILA, et al. Associations between physical activity and 30-day readmission risk in chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2014;11(5):695–705. doi:10.1513/AnnalsATS.201401-017OC

176. Nguyen HQ, Rondinelli J, Harrington A, et al. Functional status at discharge and 30-day readmission risk in COPD. Respir Med. 2015;109(2):238–246. doi:10.1016/j.rmed.2014.12.004

177. Niu Y, Xing Y, Li J, et al. Effect of community-acquired pneumonia on acute exacerbation of chronic obstructive pulmonary disease. COPD. 2021;18(4):417–424. doi:10.1080/15412555.2021.1950664

178. Njoku CM, Wimmer BC, Peterson GM, Kinsman L, Bereznicki BJ. Hospital readmission due to chronic obstructive pulmonary disease: a Longitudinal Study. Int J Health Policy Manag. 2022;09:09.

179. Ohar JA, Loh CH, Lenoir KM, Wells BJ, Peters SP. A comprehensive care plan that reduces readmissions after acute exacerbations of COPD. Respir Med. 2018;141:20–25. doi:10.1016/j.rmed.2018.06.014

180. Osman IM, Godden DJ, Friend JA, Legge JS, Douglas JG. Quality of life and hospital re-admission in patients with chronic obstructive pulmonary disease. Thorax. 1997;52(1):67–71. doi:10.1136/thx.52.1.67

181. Ozturk BO, Alpaydin AO, Ozalevli S, Guler N, Cimilli C. Self-management training in chronic obstructive lung disease improves the quality of life. Turk. 2020;21(4):266–273.

182. Ozyilmaz E, Kokturk N, Teksut G, Tatlicioglu T. Unsuspected risk factors of frequent exacerbations requiring hospital admission in chronic obstructive pulmonary disease. Int J Clin Pract. 2013;67(7):691–697. doi:10.1111/ijcp.12150

183. Pant P, Joshi A. Risk factors associated with ninety day readmission in chronic obstructive pulmonary disease exacerbation at a tertiary care hospital: a retrospective cohort study. Kathmandu Univ Med J. 2020;18(72):372–375. doi:10.3126/kumj.v18i4.49248

184. Parikh R, Shah TG, Tandon R. COPD exacerbation care bundle improves standard of care, length of stay, and readmission rates. Int J Chron Obstruct Pulmon Dis. 2016;11(1):577–583. doi:10.2147/COPD.S100401

185. Park TH, Han KT, Kim SJ, Park TH, Kim TH. Nurse staffing and 30-day readmission of chronic obstructive pulmonary disease patients: a 10-year Retrospective Study of Patient Hospitalization. Asian Nurs Res. 2016;10(4):283–288. doi:10.1016/j.anr.2016.09.003

186. Pendharkar SR, Ospina MB, Southern DA, et al. Effectiveness of a standardized electronic admission order set for acute exacerbation of chronic obstructive pulmonary disease. BMC Pulm Med. 2018;18(1). doi:10.1186/s12890-018-0657-x

187. Peng J, Yu Q, Fan S, et al. High blood Eosinophil and YKL-40 levels, as well as low CXCL9 levels, are associated with increased readmission in patients with acute exacerbation of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2021;16:795–806. doi:10.2147/COPD.S294968

188. Petite SE, Murphy JA. Impact of the implementation of a pharmacist-driven chronic obstructive pulmonary disease exacerbation orderset in an inpatient setting. Am J Health Syst Pharm. 2020;77(14):1128–1134. doi:10.1093/ajhp/zxaa119

189. Pienaar L, Unger M, Hanekom S. A descriptive study of patients admitted with acute exacerbation of chronic obstructive pulmonary disease in three hospitals in Cape Town, South Africa. Afr J Respir Med. 2015;10(2):8–12.

190. Pitta F, Troosters T, Probst VS, Spruit MA, Decramer M, Gosselink R. Physical activity and hospitalization for exacerbation of COPD. Chest. 2006;129(3):536–544. doi:10.1378/chest.129.3.536

191. Ponce Gonzalez MA, Miron Rubio M, Mujal Martinez A, et al. Effectiveness and safety of outpatient parenteral antimicrobial therapy in acute exacerbation of chronic obstructive pulmonary disease. Int J Clin Pract. 2017;71(12):e13022. doi:10.1111/ijcp.13022

192. Portoles-Callejon A, Lopez-Alfaro R, Gimenez-Miranda L, et al. Adequacy and prognostic impact of treatment for severe exacerbation of chronic obstructive pulmonary disease. Rev Clin Esp. 2020;220(7):417–425. doi:10.1016/j.rce.2019.11.003

193. Pourrashid MH, Dastan F, Salamzadeh J, Eslaminejad A, Edalatifard M. Role of Vitamin D replacement on health related quality of life in hospitalized patients with “acute exacerbation of chronic obstructive pulmonary disease”. Iran. 2018;17(2):801–810.

194. Pouw EM, Ten Velde GPM, Croonen BHPM, Kester ADM, Schols AMWJ, Wouters EFM. Early non-elective readmission for chronic obstructive pulmonary disease is associated with weight loss. Clin Nutr. 2000;19(2):95–99. doi:10.1054/clnu.1999.0074

195. Pozo-Rodriguez F, Castro-Acosta A, Alvarez CJ, et al. Determinants of between-hospital variations in outcomes for patients admitted with COPD exacerbations: findings from a nationwide clinical audit (AUDIPOC) in Spain. Int J Clin Pract. 2015;69(9):938–947. doi:10.1111/ijcp.12601

196. Price LC, Lowe D, Hosker HS, et al. UK National COPD audit 2003: impact of hospital resources and organisation of care on patient outcome following admission for acute COPD exacerbation. Thorax. 2006;61(10):837–842. doi:10.1136/thx.2005.049940

197. Puebla Neira DA, Hsu ES, Kuo YF, Ottenbacher KJ, Sharma G. Readmissions reduction program: mortality and readmissions for chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2021;203(4):437–446. doi:10.1164/rccm.202002-0310OC

198. Quintana JM, Anton-Ladislao A, Orive M, et al. Predictors of short-term COPD readmission. Intern. 2022;28:28.

199. Rahimi-Rad MH, Asgari B, Hosseinzadeh N, Eishi A. Eosinopenia as a marker of outcome in acute exacerbations of chronic obstructive pulmonary disease. Medica. 2015;10(1):10–13.

200. Revitt O, Sewell L, Morgan MDL, Steiner M, Singh S. Short outpatient pulmonary rehabilitation programme reduces readmission following a hospitalization for an exacerbation of chronic obstructive pulmonary disease. Respirology. 2013;18(7):1063–1068. doi:10.1111/resp.12141

201. Rinne ST, Elwy AR, Liu CF, et al. Implementation of guideline-based therapy for chronic obstructive pulmonary disease: differences between men and women veterans. Chron Respir Dis. 2017;14(4):385–391. doi:10.1177/1479972317702141

202. Rinne ST, Graves MC, Bastian LA, et al. Association between length of stay and readmission for COPD. Am J Manag Care. 2017;23(8):e253–e258. doi:10.1002/hec.3061

203. Rinne ST, Wong ES, Hebert PL, et al. Weekend discharges and length of stay among veterans admitted for chronic obstructive pulmonary disease. Med Care. 2015;53(9):753–757. doi:10.1097/MLR.0000000000000395

204. Roberts CM, Lowe D, Bucknall CE, Ryland I, Kelly Y, Pearson MG. Clinical audit indicators of outcome following admission to hospital with acute exacerbation of chronic obstructive pulmonary disease. Thorax. 2002;57(2):137–141. doi:10.1136/thorax.57.2.137

205. Roberts CM, Stone RA, Lowe D, Pursey NA, Buckingham RJ. Co-morbidities and 90-day outcomes in hospitalized COPD exacerbations. COPD. 2011;8(5):354–361. doi:10.3109/15412555.2011.600362

206. Roberts MH, Clerisme-Beaty E, Kozma CM, Paris A, Slaton T, Mapel DW. A retrospective analysis to identify predictors of COPD-related rehospitalization. BMC Pulm Med. 2016;16(1). doi:10.1186/s12890-016-0231-3

207. Roberts MH, Mapel DW, Petersen H. Comparative causal analysis of the effects of long-acting muscarinic antagonist versus no long-acting bronchodilator use on readmission or mortality after hospitalization for chronic obstructive pulmonary disease. Drugs Real World Outcomes. 2020;7(1):1–17. doi:10.1007/s40801-019-00171-w

208. Roberts MH, Mapel DW, Von Worley A, Beene J. Clinical factors, including all patient refined diagnosis related group severity, as predictors of early rehospitalization after COPD exacerbation. Drugs Context. 2015;4:1–15. doi:10.7573/dic.212278

209. Rodrigo-Troyano A, Melo V, Marcos PJ, et al. Pseudomonas aeruginosa in chronic obstructive pulmonary disease patients with frequent hospitalized exacerbations: a Prospective Multicentre Study. Respiration. 2018;96(5):417–424. doi:10.1159/000490190

210. Ruby D. The impact of community-acquired pneumonia on acute exacerbation of chronic obstructive pulmonary disease patients as regards in-hospital complications and early readmission. Open Respir Med J. 2020;14(1):10–15. doi:10.2174/1874306402014010010

211. Rueda-Camino JA, Bernal-Bello D, Canora-Lebrato J, et al. High doses of systemic corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease. A cohort study. Rev Clin Esp. 2017;217(9):504–509. doi:10.1016/j.rce.2017.07.012

212. Russo AN, Sathiyamoorthy G, Lau C, et al. Impact of a post-discharge integrated disease management program on COPD hospital readmissions. Respir Care. 2017;62(11):1392–1402. doi:10.4187/respcare.05547

213. Seys D, Bruyneel L, Sermeus W, et al. Teamwork and adherence to recommendations explain the effect of a care pathway on reduced 30-day readmission for patients with a COPD exacerbation. COPD. 2018;15(2):157–164. doi:10.1080/15412555.2018.1434137

214. Shah T, Churpek MM, Coca Perraillon M, Konetzka RT. Understanding why patients with COPD get readmitted: a large national study to delineate the medicare population for the readmissions penalty expansion. Chest. 2015;147(5):1219–1226. doi:10.1378/chest.14-2181

215. Shani M, Comaneshter D, Segel MJ. The importance of having good quality indicators for care of patients with COPD: a look at hospital readmission rates. Isr J Health Policy Res. 2022;11(1). doi:10.1186/s13584-022-00528-7

216. Sharif R, Parekh TM, Pierson KS, Kuo YF, Sharma G. Predictors of early readmission among patients 40 to 64 years of age hospitalized for chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2014;11(5):685–694. doi:10.1513/AnnalsATS.201310-358OC

217. Sharma G, Kuo YF, Freeman JL, Zhang DD, Goodwin JS. Outpatient follow-up visit and 30-day emergency department visit and readmission in patients hospitalized for chronic obstructive pulmonary disease. Arch Intern Med. 2010;170(18):1664–1670. doi:10.1001/archinternmed.2010.345

218. Shay A, Fulton JS, O’Malley P. Mobility and functional status among hospitalized COPD patients. Clin Nurs Res. 2020;29(1):13–20. doi:10.1177/1054773819836202

219. Shi M, Wang J, Zhang L, Yan Y, Miao YD, Zhang X. Effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease: a Nonrandomized, Comparative Study in Xi County, China. Curr Med Sci. 2018;38(3):558–566. doi:10.1007/s11596-018-1914-1

220. Shin B, Kim SH, Yong SJ, et al. Early readmission and mortality in acute exacerbation of chronic obstructive pulmonary disease with community-acquired pneumonia. Chron Respir Dis. 2019;16:147997231880948. doi:10.1177/1479972318809480

221. Simmering JE, Polgreen LA, Comellas AP, Cavanaugh JE, Polgreen PM. Identifying patients with COPD at high risk of readmission. Chronic Obstr Pulm Dis. 2016;3(4):729–738. doi:10.15326/jcopdf.3.4.2016.0136

222. Sin DD, Tu JV. Inhaled corticosteroids and the risk of mortality and readmission in elderly patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001;164(4):580–584. doi:10.1164/ajrccm.164.4.2009033

223. Singer D, Bengtson LGS, Elliott C, Buikema AR, Franchino-Elder J. Healthcare resource utilization, exacerbations, and readmissions among medicare patients with chronic obstructive pulmonary disease after long-acting muscarinic antagonist therapy initiation with soft mist versus dry powder inhalers. Int J Chron Obstruct Pulmon Dis. 2020;15:3239–3250. doi:10.2147/COPD.S284678

224. Singh G, Zhang W, Kuo YF, Sharma G. Association of psychological disorders with 30-day readmission rates in patients with COPD. Chest. 2016;149(4):905–915. doi:10.1378/chest.15-0449

225. Snider JT, Jena AB, Linthicum MT, et al. Effect of hospital use of oral nutritional supplementation on length of stay, hospital cost, and 30-day readmissions among medicare patients with COPD. Chest. 2015;147(6):1477–1484. doi:10.1378/chest.14-1368

226. Sonstein L, Clark C, Seidensticker S, Zeng L, Sharma G. Improving adherence for management of acute exacerbation of chronic obstructive pulmonary disease. Am J Med. 2014;127(11):1097–1104. doi:10.1016/j.amjmed.2014.05.033

227. Stefan MS, Pekow PS, Priya A, et al. Association between initiation of pulmonary rehabilitation and rehospitalizations in patients hospitalized with COPD. Am J Respir Crit Care Med. 2021;204(9):1015–1023.

228. Stefan MS, Pekow PS, Shieh MS, et al. Hospital volume and outcomes of noninvasive ventilation in patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease. Crit Care Med. 2017;45(1):20–27. doi:10.1097/CCM.0000000000002006

229. Stefan MS, Rothberg MB, Shieh MS, Pekow PS, Lindenauer PK. Association between antibiotic treatment and outcomes in patients hospitalized with acute exacerbation of COPD treated with systemic steroids. Chest. 2013;143(1):82–90. doi:10.1378/chest.12-0649

230. Stolz D, Christ-Grain M, Bingisser R, et al. Antibiotic treatment of exacerbations of COPD: a randomized, controlled trial comparing procalcitonin-guidance with standard therapy. Chest. 2007;131(1):9–19. doi:10.1378/chest.06-1500

231. Struik FM, Sprooten RTM, Kerstjens HAM, et al. Nocturnal non-invasive ventilation in copd patients with prolonged hypercapnia after ventilatory support for acute respiratory failure: a randomised, controlled, parallel-group study. Thorax. 2014;69(9):826–834. doi:10.1136/thoraxjnl-2014-205126

232. Stuart BC, Simoni-Wastila L, Zuckerman IH, et al. Impact of maintenance therapy on hospitalization and expenditures for medicare beneficiaries with chronic obstructive pulmonary disease. Am J Geriatr Pharmacother. 2010;8(5):441–453. doi:10.1016/j.amjopharm.2010.10.002

233. Suh ES, Mandal S, Harding R, et al. Neural respiratory drive predicts clinical deterioration and safe discharge in exacerbations of COPD. Thorax. 2015;70(12):1123–1130. doi:10.1136/thoraxjnl-2015-207188

234. Tran M, Xiang P, Rascati KL, et al. Predictors of appropriate pharmacotherapy management of COPD exacerbations and impact on 6-month readmission. J Manag Care Spec Pharm. 2016;22(10):1186–1193. doi:10.18553/jmcp.2016.22.10.1186

235. Turner AM, Sen S, Steeley C, et al. Evaluation of oxygen prescription in relation to hospital admission rate in patients with chronic obstructive pulmonary disease. BMC Pulm Med. 2014;14(1). doi:10.1186/1471-2466-14-127

236. Ushida K, Shimizu A, Hori S, Yamamoto Y, Momosaki R. Hospital frailty risk score predicts outcomes in chronic obstructive pulmonary disease exacerbations. Arch Gerontol Geriatr. 2022;100:104658. doi:10.1016/j.archger.2022.104658

237. Utens CMA, Goossens LMA, Smeenk FWJM, et al. Early assisted discharge with generic community nursing for chronic obstructive pulmonary disease exacerbations: results of a randomised controlled trial. BMJ Open. 2012;2(5):e001684. doi:10.1136/bmjopen-2012-001684

238. van Eeden AE, van de Poll I, van Vulpen G, et al. Effectiveness of case management in the prevention of COPD re-admissions: a pilot study. BMC Res Notes. 2017;10(1):621. doi:10.1186/s13104-017-2946-5

239. Vanhaecht K, Lodewijckx C, Sermeus W, et al. Impact of a care pathway for COPD on adherence to guidelines and hospital readmission: a cluster randomized trial. Int J Chron Obstruct Pulmon Dis. 2016;11(1):2897–2908. doi:10.2147/COPD.S119849

240. Vermeersch K, Belmans A, Bogaerts K, et al. Treatment failure and hospital readmissions in severe COPD exacerbations treated with azithromycin versus placebo - a post-hoc analysis of the BACE randomized controlled trial. Respir Res. 2019;20(1):237. doi:10.1186/s12931-019-1208-6

241. Wang JX, Zhang SM, Li XH, Zhang Y, Xu ZY, Cao B. Acute exacerbations of chronic obstructive pulmonary disease with low serum procalcitonin values do not benefit from antibiotic treatment: a prospective randomized controlled trial. Int J Infect Dis. 2016;48:40–45. doi:10.1016/j.ijid.2016.04.024

242. Wang Y, Stavem K, Humerfelt S, Dahl FA, Haugen T. Readmissions for COPD: propensity case-matched comparison between pulmonary and non-pulmonary departments. Clin Respir J. 2013;7(4):375–381. doi:10.1111/crj.12018

243. Werre ND, Boucher EL, Beachey WD. Comparison of therapist-directed and physician-directed respiratory care in COPD subjects with acute pneumonia. Respir Care. 2015;60(2):151–154. doi:10.4187/respcare.03208

244. Wong AW, Gan WQ, Burns J, Sin DD, van Eeden SF. Acute exacerbation of chronic obstructive pulmonary disease: influence of social factors in determining length of hospital stay and readmission rates. Can Respir J. 2008;15(7):361–364. doi:10.1155/2008/569496

245. Wu CW, Lan CC, Hsieh PC, Tzeng IS, Wu YK. Role of peripheral eosinophilia in acute exacerbation of chronic obstructive pulmonary disease. World J. 2020;8(13):2727–2737.

246. Wu H, Rhoades DA, Chen S, Brown B. Native American Patients with chronic obstructive pulmonary disease exacerbations in a tertiary academic medical center - A Pilot Study. Int J Chron Obstruct Pulmon Dis. 2021;16:1163–1170. doi:10.2147/COPD.S299178

247. Wu YK, Lan CC, Tzeng IS, Wu CW. The COPD-readmission (CORE) score: a novel prediction model for one-year chronic obstructive pulmonary disease readmissions. J Formos Med Assoc. 2021;120(3):1005–1013. doi:10.1016/j.jfma.2020.08.043

248. Xia J, Gu S, Lei W, et al. High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial. Crit Care. 2022;26(1). doi:10.1186/s13054-022-03973-7

249. Yilmaz C, Ozkan S, Erer OF. Risk assessment and rate of readmission within 30 days of discharge after hospitalization for acute exacerbation of chronic obstructive pulmonary disease. Tuberk Toraks. 2021;69(3):328–337. doi:10.5578/tt.20219705

250. Yu TC, Zhou H, Suh K, Arcona S. Assessing the importance of predictors in unplanned hospital readmissions for chronic obstructive pulmonary disease. ClinicoEcon. 2015;7:37–51.

251. Zafar MA, Loftus TM, Palmer JP, et al. COPD care bundle in emergency department observation unit reduces emergency department revisits. Respir Care. 2020;65(1):1–10. doi:10.4187/respcare.07088

252. Zafar MA, Nguyen B, Gentene A, et al. Pragmatic challenge of sustainability: long-term adherence to COPD care bundle maintains lower readmission rate. Jt Comm J Qual Saf. 2019;45(9):639–645. doi:10.1016/j.jcjq.2019.05.011

253. Zapatero A, Barba R, Ruiz J, et al. Malnutrition and obesity: influence in mortality and readmissions in chronic obstructive pulmonary disease patients. J Hum Nutr Diet. 2013;26(Supplement 1):16–22. doi:10.1111/jhn.12088

254. Zhou Y, Ameen MNATM, Li W, et al. Main pulmonary artery enlargement predicts 90-day readmissions in Chinese COPD patients. J Thorac Dis. 2021;13(10):5731–5740. doi:10.21037/jtd-21-344

255. Zhu M, Dai L, Wan L, Zhang S, Peng H. Dynamic increase of red cell distribution width predicts increased risk of 30-day readmission in patients with acute exacerbation of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2021;16:393–400. doi:10.2147/COPD.S291833

256. Sutton RT, Pincock D, Baumgart DC, Sadowski DC, Fedorak RN, Kroeker KI. An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ Digi Med. 2020;3(1):17. doi:10.1038/s41746-020-0221-y

257. Damarla M, Celli BR, Mullerova HX, Pinto-Plata VM. Discrepancy in the use of confirmatory tests in patients hospitalized with the diagnosis of chronic obstructive pulmonary disease or congestive heart failure. Respir Care. 2006;51(10):1120.

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